MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Year:2017 | Volume:39 | Issue:1 |Papers Count:16

Background: According to uncommon adaptations in blood pressure observed in response to exercise, the standardized exercise prescriptions need to be reconsidered. Therefore, prediction of blood pressure adaptations in response to exercise and detraining is needed. Methods: In this study, 70 sedentary pre-hypertensive men randomized into experimental and control groups. Experimental subjects participated in aerobic training (24 sessions(3/wk) with 60 to 70% of MHR, 40 min/session) which followed by two weeks of detraining. The data were analyzed using Pearson correlation, Kappa test, ANOVA and stepwise regression. Results: After 8 weeks of training and following to detraining some of experimental subjects experienced decline in Mean Atrial Pressure (MAP), some had no changes and some had even experienced its increasing condition (P<0. 05). All metabolic risk factors had significant changes after training and also detrainng, however; Zmets had significant changes just in those subjects with MAP decrease (P<0. 05). The metabolic risk count and also Zmets were higher in both GR (x2=52. 73, P=0. 001) and BR subjects (x2=80. 1, P=0. 001) at baseline. MAP, age, BMI and also plasma HDL and LDL values at baseline were recognized as the significant predictors of Observed changes in MAP after training (R2=0. 76, P<0. 05). Conclusions: All the Metabolic risk factors are important in predicting the direction of MAP response to training, however; participation in aerobic exercise would not possibly lead to bad responding in those with high metabolic risk factors. However, more research remains to be done because of the lack of similar evidence in this area.

Background: Diabetes increases the risk of peri-operative morbidity and mortality and research to decrease intraoperative blood glucose variations has been continued without any results. The objective of this study was to evaluate the blood glucose level in diabetics undergoing orthopedic surgeries with general or spinal anesthesia. Methods: In this prospective cross-sectional descriptive analytic study the blood glucose levels were evaluated in 80 diabetic patients undergoing orthopedic surgeries during general and spinal anesthesia before surgery, after incision, after one hour and in recovery. Results: 25 patients were male and 55 were female. The age of patients in spinal group was 64. 90± 10. 73 and in general group 60. 78± 10. 86 years old. Body Mass Index in spinal group was 27. 85± 3. 69 and in general group 29. 43± 3. 57. Blood glucose levels were not significantly different between two groups. The blood glucose levels were significant in samples taken between incision and recovery period in both groups. Conclusions: The blood glucose level during surgery and anesthesia has been increased continuously and this increase in general group had a steeper slope but it was acceptable.

Background: Coronary artery disease (CAD) is one of the major causes of mortality and morbidity. It is characterized by the activation and aggregation of the platelet, thrombus formation and myocardial infarction. During recent years, many epidemiological studies on risk factors of CAD have been performed which are fibrinogen, lipoprotein (a), and hemocystein as new CAD risk factors. The aim of the present study was to evaluate of plasminogen, fibrinogen and plasmin (PAP) levels in plasma including in patients of non-diabetic and smoker as the hemostatic parameters and their association with CAD to prevent progression of disease. Methods: In this study selected 120 subjects including 60 patients who underwent coronary angiography and 60 controls from blood donors of blood bank who had no history of CAD and liver disease and cancer. To determined Plasma levels plasminogen and PAP used ELISA Procedure (Bioassay technology laboratory kit) and plasma level of fibrinogen used Clauss method by kit of Mahsa yaran. Results: Plasma levels of plasminogen and plasmin anti plasmin (PAP) in patients with CAD were found to be significantly lower than control group (p<0. 05 both of them). Moreover Plasma level of fibrinogen in patients were significantly higher than control group (p< 0. 05). Conclusion: Elevated plasma levels of fibrinogen participate in atherogenesis leading to CAD. These finding suggested plasma level of fibrinogen can be useful as a diagnostic and monitoring marker in patients with CAD. Plasmin and plasminogen deficiency may participate in progressing CAD and thrombus formation and impaired fibrinolysis.

Background: Lead (Pb) is a one of the well-known dangerous contaminant Lead can cause disorders in theprocess of spermatogenesis. Using medicinal plants to cure impotence and lack of sex cells can have a positiveeffect. In this study, parsley extract on spermatogenesis in male rats which have received lead acetate is investigated. Methods: In the present study, 36 rats were divided into 6 groups of 6. Animals received lead acetate and extractof parsley for a period of 28 days. After 28 days, animals were weighted and were anesthetized by ether, then thebody and testis were weighted and numbers of spermatocytes, spermatogonia, Leydig cells were studied. Theobtained results were analyzed by ANOVA and Tukey tests. Results: Lead acetate significantly decreased the spermatocytes, spermatogonia, Leydig cells. Parsley extractwith 200 mg/kg dose could lead to a significant increase of sperms in the tube lumen (p<0. 05). Conclusion: Parsley’ s extract effect on spermatogenesis in male rats which received lead acetate was justified.

Background: cyclooxygenase-2 (cox-2) is involved in pathogenesis of various tumors and possibly malignant skin tumors including malignant melanoma; however, there is not enough information about cox-2 expression in benign melanocytic lesions. In the present study we compared the expression levels of cox-2 in malignant melanoma and benign melanocytic lesions. Methods: In this analytical study, 42 malignant melanoma from all 4 subtypes and 38 benign melanocytic lesions including dysplastic nevus, Spitz nevus and atypical nevus were evaluated for cox-2 expression using immunohistochemistry staining and intensity of cell staining (quantitatively and qualitatively). Results: Malignant melanoma compared to benign melanocytic lesions had significantly higher levels of staining (p<0. 001), and much more intense coloration (p<0. 001) and higher overall staining score (p<0. 001). Regarding the cox-2 staining between malignant melanoma subtypes, all four subtypes mostly had staining intensity over 60%. Also in terms of quality, the most intense staining was in the ALM, and LM and NM had moderate staining intensity. With increasing depth of involvement, cox-2 staining increases. Intensity of cell staining was also higher in cases with tumor depth of 2-4 mm. Conclusion: The results indicate the effectiveness of cox-2 in differentiating between malignant melanoma and benign melanocytic lesions. cox-2 expression correlated with the depth of invasion. Although cox-2 alone cannot be used to differentiate melanoma from benign lesions, it can be helpful in combination with other methods, in determining the prognosis and future targeted therapies.

Background: Spread of pathogenic strains carrying genes Extended-spectrum beta-lactamases (ESBL) is one of the major health concerns in the world. These genes caused due to the inefficient beta-lactam antibiotics in the treatment of infectious diseases. The purpose of this study was to determine the prevalence of TEM-1 and SHV-1 beta-lactamase genes in uropathogenic E. coli isolates from the city of Khorramabad. Methods: A total of 100 E. coli isolates were collected from patients with urinary tract infections in clinical laboratories from city of Khorramabad. Originality isolates were confirmed by biochemical tests. ESBLs positives isolates were determined by using a combined disk based instruction the Clinical and Laboratory Standards Institute (CLSI) and then all the positive isolates were studied by PCR assay for the presence of genes TEM-1 and SHV-1. Results: Thirty one (31%) out of 100 E. coli isolates were ESBL positive based on the results of combined disc tests. PCR analysis using the specific primers revealed that 18 isolates (58. 06%) contained β – lactamases genes encoding TEM, and while none of isolates did not carry SHV gene. Conclusion: The relatively high prevalence of resistance genes to third generation of cephalosporins among the E. coli isolates was found which indicates a challenge in successful treatment with current antibiotics.

Background: Diabetic Ketoacidosis (DKA) is one of emergency conditions caused by acute hyperglycemia in diabetic patients. The main treatment is injection of rapid-acting Regular insulin. This study was aimed to investigate the effect of Glargine insulin on recovery of patients with DKA. Methods: A randomized clinical trial (RCT) conducted on 40 patients (twenty patients in each group) with DKA. Both groups received standard treatment regimen for DKA. In addition, the experimental group was given 0. 4 U/kg of insulin glargine. Results: The mean duration of acidosis correction time and recovery from DKA was 13. 77± 6. 10 hours in the case group and 16. 91± 6. 49 hours in control group (p=0. 123). The mean dosage of regular insulin until recovery from DKA was 84. 8± 45. 6 units in the case group and 116. 5± 91. 6 units in control group (p=0. 17). Hypokalemia (p=1) and hypoglycemia (p=1) were not different between two groups. In 35% of samples in case group and 51% in controls, the blood sugar (BS) was more than 180 mg/dl for 24 hours after discontinuation of the insulin infusion (p=0. 046). The mean duration of hospitalization was 5. 1± 1. 88 days in case and 5. 9± 2. 19 days in control group (p=0. 225). Conclusion: Adding insulin Glargine to the standard treatment regimen of DKA significantly reduced rebound hyperglycemia without incurring episodes of hypoglycemia and hypokalemia. It also reduced the average time of recovery from DKA, regular insulin consumption and hospital length, although these changes were not statistically significant. It seems that the non-significant difference be related to the paucity of sample size and close monitoring of patients.

Background: Keratoconus is a progressive and non-inflammatory cornea ectasia in central and paracentral of cornea, developed by progressive thinning and protrusion and cone formation. Despite use of spectacles and contact lens for improvement of vision, these methods were impracticability and unsatisfactory. Our aim in this study was to assess effect of Intrastromal corneal ring segment (keraring) implantation on corneal biomechanical parameters. Methods: In clinical trial study, 21 keratoconic eyes with inclusion criteria were selected and placed ICRS (keraring) and biomechanical characteristics were assessed preoperation and 1 and 6 months after surgery with ocular response analyzer. Result: Mean CRF and CH and difference CH-CRF measures were not significant in this study at 1 and 6 months after surgery. Mean difference of k1, k2 at 1 and 6 months after surgery were significant comparing to pre-operation results (p=0. 02). IOPg and IOPcc were not significant in post operation than preoperation. Waveform score measures were significant in post operation than preoperation. Change of CH-CRF with waveform score change measures were significantly difference (p=0. 02, R=0. 31). CCT were not significant in post operation than pre operation. Changes of CCT measures had significant relation with change of IOPcc (p=0. 02, R=0. 40). Change of CCT measures had significant relation with change of CH-CRF (p=0. 02, R=0. 11) Conclusion: Keraring made change of corneal shape but did not changed biomechanical properties.

Background: Movement therapy has known as a method to reduce pain and increase muscle strength in patients with low back pain. The aim of this study was to determine the effect of aquatic therapy on maximum muscle activity and pain intensity in men with non-specific chronic low back pain. Methods: Thirty male subjects with non-specific chronic low back pain were randomly divided into two aquatic therapy group (n=15) and control group (n=15). Before and after intervention, subjects were assessed by maximum activity of lumbar erector spine muscles and pain severity. A 24 session protocol of aquatic therapy, sixty minutes per session lasting for 6 weeks and four sessions a week were applied. Subjects in control group didn’ t receive any therapeutic modality during the study period. The collected data were analyzed using independent-T test and paired samples-T test. The significance level was (p≤ 0. 05). Results: No significant difference before and after intervention in maximum muscle activity of the Right and left upper and lower lumbar-erector spine muscles were observed (p>0/05). However, the results about the pain intensity between the two groups showed significant difference in pre and post-test (p<0/05). Conclusion: Aquatic therapy program had no significant effect on electromyography activity of erector spine muscles and disorders of lumbar muscles in men with NCLBP. However, this method of treatment reduced pain intensity in these patients significantly, that this reduction in pain may be due to neurological and physiological factors.

Background: Benign prostatic hyperplasia (BPH) is one of the common problems in older men which in many cases need to be treated. However, the incidence of inguinal hernia increases with age and a significant number of patients with symptoms of BPH, have concurrent inguinal hernia. Although simultaneous suprapubic prostatectomy and inguinal herniorrhaphy is one of the treatment options, but routinely it is not used. This study was aimed to evaluate the results of this surgical procedure. Methods: In this study. 122 patients who were underwent open suprapubic prostatectomy and simultaneous preperitoneal herniorrhaphy with polypropylene mesh application, were evaluated and outcomes and complications of this procedure was recorded. Results: Of 122 patients were enrolled, 38 (31. 1%) patients had bilateral inguinal hernia, of 170 hernias, 29 were direct inguinal hernia and 141 were indirect. of 84 patients with unilateral hernia 33 patients had inguinal hernia on the left side and 51 patients on the right side. The median clinical follow-up time was 26. 4 months (range 12-48 months). During the follow-up period, surgical site infection, hematoma, chronic pain and hernia recurrence were not detected. Three patients (2. 5%) had hydrocele after surgery. In all patients, the surgical outcomes were satisfactory. Conclusions: According to the results, simultaneous prostatectomy and preperitoneal herniorrhaphy with mesh application is a convenient procedure which can be easily performed, furthermore it is cost effective, time-saving and achieves good outcomes for patients.

Background: Pseudomonas aeruginosa is a gram negative bacillus. Infection with these bacteria usually occurs in patients who hospitalized due to: need for prolonged stay in ICU, those who have intravascular catheters, or indwelling urinary catheters. This Study investigates in vitro susceptibility of pseudomonas aeruginosa which were isolated from patients with UTI to doxycycline, tigecycline, ceftazidime, cefepime, piperacillin/tazobactam, impipenem, meropenem, colistin, ciprofloxacin, nitrofurantoin, amikacin) with standard disk diffusion. Comparing the, susceptibility results of disk diffusion with E. test for doxycycline and tigecycline is another aim. Other purpose of this study was to define MDR pseudomonas aeruginosa susceptibility to doxycycline and tigecycline. Methods: Sixty pseudomonas aeruginosa which was isolated after biochemical and bacteriological test, were entered to study and susceptibility to above antibiotics was tested by disk diffusion. For doxycycline and tigecycline antibiogram by two methods were performed: disk diffusion and Etest. Result: Maximum susceptibility was observed for colistin =95% followed by sensitivity in decreasing order for these antibiotics. Meropenem 76% Imipenem= Cefepime= Ceftazidime 63. 3% Piperacillin/tazobactam 55% doxycycline 46% amikacin 45% Ciprofloxacine 35% Tigeycline 15% nitrofurantoin 0%. Measurement of kappa for agreement of two methods of antibiograms revealed moderate agreement in this regard. Conclusion: In vitro susceptibility of isolated pseudomonas aeruginosa to studied antibiotics (with exception of colistin) was less than 80% even for carbapenems. Disk diffusion for doxycycline and tigecycline wasn’ t effective for differentiation intermediate resistance from sensitive. Calculation of cohens Kappa for agreement was moderate. Most of MDR pseudomonas aeruginosa was resistant to doxycycline and tigecycline.

Background: Infertility is defined as a lack of conception in a couple that has been having unprotected intercourse, for one year. Despite enormous progresses in the understanding of human reproductive physiology, the underlying causes of male infertility remains undefined in about 50. 0% of cases, which are referred to as idiopathic infertility. Human apurinic/apyrimidinic endonuclease (ApE1) is a multifunctional protein that has an important role in the base excision repair (BER) pathway. ApE1-141 T>G polymorphism is located in the promoter region. The aim of this study was to investigate the relation between ApE1-141T>G polymorphism and idiopathic male infertility. Methods: In this case-control study, Samples were collected from 90 patients diagnosed with idiopathic male infertility and also from 60 control subjects. Collected samples were genotyped by allele-specific PCR (AS-PCR). Results: There was significantly association between-141T>G polymorphism and idiopathic male infertility (p = 0. 022). Conclusion: The polymorphism 141T>G can be associated with male infertility. However, further studies are needed to confirm the results.

Because of some reasons local flaps are not suitable in the cases with upper extremity injuries. lattismus dorsi flaps are recommended in these cases. We present a twenty eight years old male with upper extremity trauma with type 3C left homerus fracture and destruction of triceps. Reconstruction made using lattismus dorsi flap and in a two month follow up we find a 30o Extention lag comparing to the right elbow while the patient had cosmetically satisfaction.